Anti Fungal and Malaria

Question 1

What do azoles target?

Answer 1

ergosterol

Question 2

What does Amphotericin B target?

Answer 2

Bind to ergosterol and creates leaky pores

Question 3

Amphotericin B: ADEs

Answer 3

1. Nephrotoxic

2. Infusion reactions (chills, fever, muscle spasms, hypotension)

Question 4

Flucytosine: ADEs

Answer 4

1. Renal excretions

2. Myelosuppression (suppression of stem blood cells)

Question 5

Which Azole is eliminated in the urine unchanged?

Answer 5

Fluconazole

Question 6

Which Azole is best for aspergillosis?

Answer 6

Voriconazole

Question 7

Which Azoles are best for Blastomycosis?

Answer 7

1. Itraconazole

2. Fluconazole

Question 8

Which Azole is best for Mucormycosis?

Answer 8

posaconazole

Question 9

Why isn’t ketoconazole used in systemic fungal infections?

Answer 9

inhibits hepatic and adrenal P450s

Question 10

Azoles: ADEs

Answer 10

• tough on the liver
• GI upset
• Rash

Question 11

Voriconazole: ADEs

Answer 11

• visual disturbances

- Class D in pregnancy

Question 12

Which antifungal is best taken orally for mucocutaneous fungal infections because it can accumulate in keratin?

Answer 12

Terbinafine

Question 13

What is first line therapy for aspergillus infection?

Answer 13

Voriconazole

Question 14

What is first line therapy for everything but aspergillus?

Answer 14

Amphotericin B

Question 15

What are the 3 most important ADEs of antifungals?

Answer 15

1. Heptatic transaminases
2. Rash, photosensitivity
3. GI upset

Question 16

Name 3 diseases caused by protozoa?

Answer 16

1. Malaria
2. Giardia
3. Trichomoniasis

Question 17

What is the treatment(s) of choice for Malaria?

Answer 17

Doxycycline*
Chloroquine
Mefloquine

Question 18

Which anti-malaria drugs are for treatment and chemoprophylaxis?

Answer 18

1. Chloroquine*
2. Mefloquine
3. Primaquine* (also treats other plasmodiums)
4. Atovaquone-proguanil
5. Doxycycline

Question 19

What is the drug of choice for malaria prevention in travelers?

Answer 19

Chloroquine**

if resistance–> Malarone, Mefloquine

Question 20

What is the drug of choice in malaria prevention in travelers if multi-drug resistance?

Answer 20

Doxycycline

Question 21

What should you advise your patient to avoid if they are taking Metronidozole?

Answer 21

alcohol as it will cause violent stomach upset and vomiting

Question 22

Which malaria drug should be avoided in neurological disorders?

Answer 22

Chloroquine

Question 23

Which malaria drug should be avoided in mental health problems?

Answer 23

Mefloquine

Question 24

Which malaria drug should be avoided in pregnant women/breast feeding women?

Answer 24

Proguanil with atovaquone

Doxycycline (also don’t give this to kids under 8)

Question 25

Treatment for leishmaniasis?

Answer 25

Sodium stibogluconate

Question 26

Pneumocystis jirovecii treatment?

Answer 26

TMP-SMX

Question 27

Treatment for tichomonas vaginalis?

Answer 27

Metronidazole